Abstract：
Magnetic resonance-guided focused ultrasound (MRgFUS) is a non-invasive lesioning technique used to treat movement disorders such as essential tremor (ET), Parkinson\'s disease (PD), and X-linked dystonia-parkinsonism (XDP). We would like to report our experience in establishing and developing our MRgFUS program and preliminary results. Adult patients with tremor-dominant PD (TDPD), ET, and XDP were considered for initial screening (neurologic evaluation, skull density ratio [SDR] determination). Eligible patients underwent secondary screening (neurosurgical and neuropsychological evaluation, psychiatric and medical clearance). During the procedure, a neuro-anesthesiologist and neurologist were also present to monitor the patient and perform neurologic evaluation, respectively. Clinical follow-up was scheduled at 2 weeks post-treatment, then at every 3 months. A total of 30 patients underwent MRgFUS treatment: 22 TDPD, 6 XDP, and 2 ET. The mean age was 55.7 years, and majority were male (86.7%). Mean disease duration was 8.6 years. Mean SDR was 0.46. The targets for TDPD and ET were the contralateral ventral intermediate nucleus of the thalamus; for XDP, it was the pallidothalamic tract. The mean maximum temperature was 59.8oC; number of sonocations, 7.3; and treatment time, 64.6 min. Majority of patients improved after the procedure. Transient intraprocedural adverse events (headache, dizziness) were reported in 20% of patients while post-procedural events (mild weakness, numbness) were seen in 16.7%. Only 26.7% of patients had follow-up data. Despite the unique challenges encountered, MRgFUS treatment is feasible in resource-limited settings. Additional steps would have to be made to develop and improve the program.
摘要：
磁共振引导聚焦超声（MRgFUS）是一种非侵入性损伤技术，用于治疗运动障碍，如特发性震颤（ET），帕金森病（PD），和X连锁肌张力障碍-帕金森病（XDP）。我们想报告我们在建立和发展MRgFUS计划和初步结果方面的经验。成人患者以震颤为主的PD（TDPD），ET,和XDP被考虑用于初步筛查(神经系统评估，颅骨密度比[SDR]测定)。符合条件的患者接受二次筛查(神经外科和神经心理学评估，精神病学和医学许可)。在手术过程中,神经麻醉师和神经科医生也在场，以监测患者并进行神经系统评估，分别。临床随访安排在治疗后2周，然后每三个月。共有30例患者接受MRgFUS治疗：22TDPD，6XDP,2ET平均年龄为55.7岁,大多数为男性(86.7%)。平均病程为8.6年。平均SDR为0.46。TDPD和ET的目标是丘脑对侧腹侧中间核；对于XDP，那是苍白丘脑道。平均最高温度为59.8oC；超声检查次数，7.3；和治疗时间，64.6min.大多数患者在手术后好转。暂时性术中不良事件（头痛，头晕）在20％的患者中报告，而术后事件（轻度虚弱，麻木）见于16.7%。只有26.7%的患者有随访数据。尽管遇到了独特的挑战，MRgFUS治疗在资源有限的环境中是可行的。必须采取其他步骤来开发和改进该计划。
